Neurocognitive and social cognitive training for youth at clinical high risk (CHR) for psychosis: A randomized controlled feasibility trial

Schizophr Res. 2022 May:243:302-306. doi: 10.1016/j.schres.2020.09.005. Epub 2020 Sep 22.


Background: Cognitive deficits are present in individuals at clinical high risk for psychosis (CHRP). We developed Cognition for Learning and for Understanding Everyday Social Situations (CLUES), an integrated social- and neurocognitive remediation intervention for CHRP, and examined its feasibility and efficacy compared to an active control intervention in a pilot randomized controlled trial.

Method: Thirty-eight individuals at CHR-P were randomized to CLUES or Enriched Acceptance and Commitment Therapy (EnACT). Participants were assessed at baseline, end of treatment and 3-month follow-up for changes in social/role functioning, neuro- and social cognition, and symptoms.

Results: Social functioning significantly improved for participants in CLUES over EnACT, at end of treatment and 3-month follow-up. CLUES participants also showed greater improvements in social cognition (theory of mind and managing emotions).

Conclusion: The results support feasibility of CLUES and suggest preliminary efficacy. Future randomized controlled trials of CLUES in a larger sample, with additional treatment sites, could help determine efficacy of CLUES, and investigate whether CLUES can be effectively implemented in other settings.

Keywords: Acceptance and commitment therapy; Clinical high risk for psychosis; Cognitive remediation; Randomized controlled trial; Schizophrenia; Treatment.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acceptance and Commitment Therapy*
  • Adolescent
  • Cognition
  • Feasibility Studies
  • Humans
  • Psychotic Disorders* / psychology
  • Psychotic Disorders* / therapy
  • Randomized Controlled Trials as Topic
  • Schizophrenia* / therapy
  • Social Cognition